Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2008 Jun 15;111(12):5515-23.
doi: 10.1182/blood-2007-10-117150. Epub 2008 Mar 11.

Twenty-five-year follow-up among survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study

Rajen Mody  1 , Suwen Li, Douglas C Dover, Stephen Sallan, Wendy Leisenring, Kevin C Oeffinger, Yutaka Yasui, Leslie L Robison, Joseph P Neglia
Affiliations
Multicenter Study

Twenty-five-year follow-up among survivors of childhood acute lymphoblastic leukemia: a report from the Childhood Cancer Survivor Study

Rajen Mody et al. Blood. .

Abstract

Survivors of childhood acute lymphoblastic leukemia (ALL) are at risk for late effects of cancer therapy. Five-year ALL survivors (< 21 years at diagnosis; n = 5760 eligible, 4151 participants), diagnosed from 1970 to 1986 were compared with the general population and a sibling cohort (n = 3899). Cumulative mortality of 5760 5-year survivors was 13% at 25 years from diagnosis. Recurrent ALL (n = 483) and second neoplasms (SNs; n = 89) were the major causes of death. Among 185 survivors, 199 SNs occurred, 53% in the CNS. Survivors reported more multiple chronic medical conditions (CMCs; odds ratio [OR], 2.8; 95% CI, 2.4-3.2) and severe or life-threatening CMCs (OR, 3.6; 95% CI, 3.0-4.5) than siblings. Cumulative incidence of severe CMCs, including death, 25 years from diagnosis was 21.3% (95% CI, 18.2-24.4; 23.3% [95% CI, 19.4-27.2] and 13.4% [95% CI, 8.4-18.4] for irradiated and nonirradiated survivors, respectively). Survivors reported more adverse general and mental health, functional impairment, and activity limitations compared with siblings (P < .001). Rates of marriage, college graduation, employment, and health insurance were all lower compared with sibling controls (P < .001). Long-term survivors of childhood ALL exhibit excess mortality and morbidity. Survivors who received radiation therapy as part of their treatment or had a leukemia relapse are at greatest risk for adverse outcomes.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Overall survival of ALL survivors. (A) Overall survival of ALL survivors in comparison with US population. For panels A and C, assessment of late mortality included all 5760 patients of the 5778 eligible 5-year ALL survivors, excluding 18 Canadians who were not covered by NDI search and did not fill out any questionnaire. (B) Overall survival in ALL survivors with and without history of irradiation. (C) Overall survival of ALL survivors in different treatment era.
Figure 2
Figure 2
Cumulative incidence of SNs in ALL survivors with and without history of irradiation.
Figure 3
Figure 3
Cumulative incidence of severe chronic medical conditions in ALL survivors with and without history of irradiation.
See this image and copyright information in PMC

References

    1. Pui CH. Childhood leukemias. N Engl J Med. 1995;332:1618–1630. - PubMed
    1. Young JL, Jr, Ries LG, Silverberg E, et al. Cancer incidence, survival, and mortality for children younger than age 15 years. Cancer. 1986;58:598–602. - PubMed
    1. Gurney JG, Severson RK, Davis S, et al. Incidence of cancer in children in the United States: sex-, race-, and 1-year age-specific rates by histologic type. Cancer. 1995;75:2186–2195. - PubMed
    1. Reis LAG, Eisner MP, Kosary CL, et al., editors. SEER cancer statistics review, 1973-1998. Bethesda, MD: National Cancer Institute; 2001.
    1. Brenner H, Kaatsch P, Burkhardt-Hammer T, et al. Long-term survival of children with leukemia achieved by the end of the second millennium. Cancer. 2001;92:1977–1983. - PubMed

Publication types

MeSH terms